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Stress
Stress (roughly the opposite of relaxation) is a medical term for a wide range of strong external stimuli, both physiological and psychological, which can cause a physiological response called the general adaptation syndrome, first described in 1936 by Hans Selye in the journal Nature. Detailed definitions Stress may also be defined as "the sum of physical and mental responses to an unacceptable disparity between real or imagined personal experience and personal expectations." By this definition, stress is a response which includes both physical and mental components. The physical responses include a host of physiological changes which largely fall into acute response, and chronic response. Acute response is approximately that discussed by Hans Selye. Chronic response is more complex and subtle, and has not been fully delineated. Selye presented his concepts in the General Adaption Syndrome, where the organism used diverse mechanisms to adapt to stressors, for example the flight or fight response, and return to a homeostatic state (Claude Bernard, Walter Cannon). Later in his career, he proposed two levels of stress resistance: a superficial which could be replenished, and a deep which could not. Mental responses to stress include adaptive ("good") stress, anxiety, and depression. Where stress enhances function (physical or mental) it may be considered "good" stress. However, if stress persists and is of "excessive" degree, it eventually leads to a need for resolution, which may lead either to anxiety (escape) or depressive (withdrawal) behaviors—these observation could add immensely to philosophy, religion, ethics, and law, but it would stress those systems to adapt to this knowledge, and the outcome is doubtful. One may further appreciate from that definition that stress may derive from imagined experience such as stress felt during a frightening movie). Further, the fulcrum of stress response is the presence of disparity between experience (real or imagined) and personal expectations. A person living in a fashion consistent with personally-accepted expectations has no stress even if the conditions might be interpreted as adverse from some outside perspective—rural people may live in comparative poverty, and yet be unstressed if there is sufficiency according to their expectations. Finally, where there is chronic disparity between experience and expectations stress may be relieved by acceptance. However, since acceptance is rarely complete—except in children—stress resolution by this approach is also rarely complete. It has been said that stress is often a reaction to a crisis of predictability, further that mind is solely an instrument of prediction, and that the body may be divided into a vegetative process and an integrative process. Types of stress Any factor that causes stress is called a stressor. There are two kinds of stressors: processive stressors and systemic stressors. Processive stressors are elements in the environment perceived by the organism as potential dangers. These do not cause damage directly, but are processed in the cerebral cortex. The processed information is then sent via the limbic system in the hypothalamus, where they activate the supreme centers of the autonomic nervous system. This results in the fight-or-flight (or sympathetico-adrenal) response. Systemic stressors cause a disturbance in the organism's homeostasis, as well as tissue necrosis, hypotension and/or hypoxia. Often both types of stressors occur simultaneously. They are usually accompanied by pain and/or intensive emotions. Mental responses to stress include adaptive (good) stress, anxiety, and depression. Where stress enhances function (physical or mental) it may be considered good stress. However, if stress persists and is of excessive degree, it eventually leads to a need for resolution, which may lead either to anxious (escape) or depressive (withdrawal) behavior. One may further appreciate from that definition that stress may derive from imagined experiences such as frightening movies. Further, the fulcrum of stress response is the presence of disparity between experience (real or imagined) and personal expectations. A person living in a fashion consistent with personally-accepted expectations has no stress even if the conditions might be interpreted as adverse from some outside perspective — rural people may live in comparative poverty, and yet be unstressed if there is a sufficiency according to their expectations. Finally, when there is chronic disparity between experience and expectations, stress may be relieved by acceptance. However, since acceptance is rarely complete except in children, stress resolution by this approach is also rarely complete. It has been said that stress is often a reaction to a crisis of predictability, that the mind is solely an instrument of prediction, and that the body may be divided into a vegetative process and an integrative process. Effects of stress *Stress and mental disorders *Stress and physical disorders Causes of stress Both negative and postive stressors can lead to stress. Below is a non-exhaustive list of common stressors in people's lives: *Environmental stress: Elevated sound levels, Bright light *Economic stress: Deprivation, Unpaid bills, lack of money *Occupational stress: Organizational crises ***Work/study: exams, rush hour traffic, project deadlines *Physiological stress: (un-healthy eating, smoking, heavy drinking, not getting enough sleep, etc.),aging, Pain *Psychological stress: Existential crisis **Personal relationships:bullying, caregiver burden, conflict, deception, **Exposure to stress early on in life can permanently enhance the stress response (ie: abused children) *Social stress, Life events Family conflicts: births, deaths, rape, war, reunions, weddings, divorce, moving, chronic illness, crises, disasters, loss of role, identity crisis. One evaluation of the different stresses in people's lives is the Holmes and Rahe Stress Scale. Stress and its effects Selye was able to separate the physical effects of stress from other physical symptoms suffered by patients through his research. He observed that patients suffered physical effects not caused directly by their disease or by their medical condition. Selye described the general adaptation syndrome as having three stages: * alarm reaction, where the body detects the external stimuli * adaptation, where the body engages defensive countermeasures against the stressor * exhaustion, where the body begins to run out of defenses There are two types of stress: eustress ("positive stress") and distress ("negative stress"), roughly meaning challenge and overload. Both types may be the result of negative or positive events. If a person both wins the lottery and has a beloved relative die on the same day, one event does not cancel the other — both are stressful events. Eustress is essential to life, like exercise to a muscle, however distress can cause disease. (Note that what causes distress for one person may cause eustress for another, depending upon each individual's life perception.) When the word stress is used alone, typically it is referring to distress. Serenity is defined as a state in which an individual is disposition-free or largely free from the negative effects of stress, and in some cultures it is considered a state that can be cultivated by various practices, such as meditation, and other forms of training. Stress can directly and indirectly contribute to general or specific disorders of body and mind. Stress can have a major impact on the physical functioning of the human body. Such stress raises the level of adrenaline and corticosterone in the body, which in turn increases the heart rate, respiration, and blood pressure and puts more physical stress on bodily organs. Long-term stress can be a contributing factor in heart disease, high blood pressure, stroke and other illnesses. The Japanese phenomenon of karoshi, or death from overwork, is believed to be due to heart attack and stroke caused by high levels of stress. The link between emotions and physical health is further supported by this paragraph from James A. Duke's The Green Pharmacy Herbal Handbook about the research of Dean Ornish, M.D: Dr. Ornish tells about a group of rabbits that added an unexpected tidbit to the research on heart disease. Kept in a laboratory under research conditions, the rabbits were genetically similar, and all received the same food and got the same amount of exercise; yet one group had 60 percent fewer heart attacks than the others. What was the difference? It turned out that the healthier rabbits were the ones kept in the lower cages, and the short person who fed the rabbits could reach the lower animals and pet them when feeding them. Love, it seems, is a life preserver. http://www.mothernature.com/Library/Bookshelf/Books/41/63.cfm Coping with stress Individuals can respond very differently to the same stressor; any given situation can cause eustress in one person and distress in another. This happens because of differences in physiology and life circumstances, as well as different methods of stress management. Methods of coping that work well in childhood situations often become ingrained and habitual, and often follow the child into adulthood. In the adult world, these skills can be quite inappropriate, and stress heightens as the person clings to obsolete behaviors. However, new skills can be learned, and poor coping methods replaced. There are currently many classes, books, and seminars available to help people develop better habits of managing stress. Other approaches to dealing with stress include The Alexander Technique, Shiatsu, T'ai Chi Ch'uan, yoga and meditation. For example, when Selye reviewed the physiological changes measured in practitioners of transcendental meditation ™, he concluded that such changes were the opposite of the body's reaction to stress. The therapeutic effect of TM was most distinct in people whose coping skills were poorly adapted to the stress of daily life. Finally, a number of psychological and sociological factors have been consistently demonstrated to act as a moderator against stress in the development of chronic psychological or physical disease (such as depression or hypertension). Among these many factors are chiefly: optimism or hope, social support, Socioeconomic status (SES), sense of community, and others. Neurochemistry and physiology The general neurochemistry of the general adaptation syndrome is now believed to be well understood, although much remains to be discovered about how this system interacts with others in the brain and elsewhere in the body. The body reacts to stress first by releasing catecholamine hormones, epinephrine and norepinephrine, and glucocorticoid hormones, cortisol and cortisone. The hypothalamic-pituitary-adrenal (HPA) axis is a major part of the neuroendocrine system, involving the interactions of the hypothalamus, the pituitary gland and the adrenal glands. The HPA axis is believed to play a primary role in the body's reactions to stress, by balancing hormone releases from the adrenaline-producing adrenal medulla and from the corticosteroid producing adrenal cortex. Stress Management Techniques The following activities, actions, and descriptions listed below, as well as any other means in relieving or reducing stress, can be coined stress management techniques. Stress management techniques allow for stress reduction through applications of exercise, medicine, personal analysis—this can effortlessly be achieved by attending therapy sessions with a psychologist, for example—or can even be as simple as devoting an increment of one's day for personal time. Stress management techniques are broadly used today as the negative health effects of a stress overload can be detrimental to one's daily functioning. As for chronic stress, the consistent application of stress over a period of time can seriously impair one's mental, physical, and even social functionings. Studies show chronic stress is extremely unhealthy in numerous aspects: those who are stressed are more suspectible to a myriad of diseases ranging from high blood pressure to forms of skin cancer, as studies within the scientific realm have most recently shown. For optimal health and wellness it is vital to undertake a stress management technique in attempts to reduce, if not ideally completely eliminate, stress or the situation that is facilitating it. Below are some methods of stress management techniques: Relaxation Response as a relief of stress Herbert Benson, M.D. developed a technique called The Relaxation Response, which makes the basic steps of meditation easy to understand and apply. Dr. Benson’s website offers the following steps as a simple way to begin practicing meditation: *Pick a focus word, short phrase, or prayer that is firmly rooted in your belief system, such as "one," "peace," "The Lord is my shepherd," "Hail Mary full of grace," or "shalom." *Sit quietly in a comfortable position. *Close your eyes. *Relax your muscles, progressing from your feet to your calves, thighs, abdomen, shoulders, head, and neck. *Breathe slowly and naturally, and as you do, say your focus word, sound, phrase, or prayer silently to yourself as you exhale. *Assume a passive attitude. Don't worry about how well you're doing. When other thoughts come to mind, simply say to yourself, "Oh well," and gently return to your repetition. *Continue for ten to 20 minutes. *Do not stand immediately. Continue sitting quietly for a minute or so, allowing other thoughts to return. Then open your eyes and sit for another minute before rising. *Practice the technique once or twice daily. Good times to do so are before breakfast and before dinner. (Mind-Body Medical Institute) Walking meditations as a relief of stress There are more active forms of meditation as well, such as the walking meditations taught by the Vietnamese Buddhist monk Thich Nhat Hanh and Jon Kabat-Zinn of the University of Massachusetts Medical Center. Walking meditations employ the practice of mindfulness, which involves being fully engaged in whatever is happening in the present moment, without becoming involved in thinking about it. Therefore, when you walk you focus on each step, the sensation of the feet touching the ground, the rhythm of the breath while moving, and the feel of wind against your face. This type of meditation is "portable", and can be practiced in other activities, such as driving or engaging in work tasks. Mindfulness meditation relieves stress because it relieves preoccupation with the habitual thoughts about the past or the future that perpetuate stress. As mind-body medicine pioneer Joan Borysenko, Ph.D., says, "Meditation helps to keep us from identifying with the ‘movies of the mind.’" Another meditation technique involves guided imagery or visualizations. In this method, the meditator imagines a scene wherein he or she feels very at peace and is able to let go of all concerns and tensions. In many cases, this form of meditation is practiced by listening to guided audio instructions. Visit the online guided meditations section of the references and resources for a sampling of some free guided meditations. Tai Chi as a relief of stress Tai Chi Chuan, or Tai Chi for short, is a self-paced, non-competitive series of slow, flowing body movements (“forms”) that emphasize acute concentration, relaxation, and the conscious circulation of vital energy throughout the body. Though Tai Chi evolved as a martial art sometime in the 13th century, it is primarily practiced today as a way of calming the mind, conditioning the body, and reducing stress. The basis of Tai Chi is the principle of “softness defeating hardness.” Proper stance, which involves lowering the center of gravity (“sinking”), is emphasized over muscular strength as a way to access one’s innate power. Depending on the style of Tai Chi taught, there are between 13 and 108 forms that make up a set when performed continuously. As in meditation, Tai Chi employs focusing on the breath and mindfulness, or maintenance of the mind’s attention in the present moment and merging it with daily motions. Tai Chi Practitioners say moving meditation is, 10, 100, 1000 times better than sitting meditation. In the Chinese system, one works in the the world through ones productive years, but as one passes into retirement one strives to attain a near continuos meditation in one's life, cultivating one's garden. Tai Chi works with the concept of Qi (pronounced “chee”) —a “bio-energy” that moves throughout the body via invisible energy channels called meridians. Qi regulates and maintains health in the various systems of the body by supplying healing energy to the organs. When there are constrictions in the movement of Qi due to injury, a “slumping” posture, or other problems, “dis-ease” or stress results. The muscular movements of Tai Chi remove any blockages and stimulate the Qi to flow freely. Tai Chi is especially suited for older adults because of its low impact movements. Reported health benefits: *Less stress and more peace of mind. *Improved ability to deal with difficult situations. *Improved balance and proprioception (internal body awareness). *More strength, stamina, and suppleness. *Improved functioning of the internal organs. *Easier breathing and better sleep. *Improve balance and minimize falls. *It is self-paced and noncompetitive. *You don't need a large physical space, special clothing or equipment. *It is easy to do in groups as well as by yourself. *You can add new movements as you become more proficient. *The International Taoist Tai Chi Society provides a World Directory of Tai Chi practitioners as a way to find qualified instruction near you. Other activities as relief of stress Sleep While there are many things you can do to reduce stress, the first line of defense against stress is to make sure you are getting enough sleep. Sleep restores the body systems and provides rejuvenation. Sleep-deprived bodies will be too depleted to perform the important stress-reducing physical and mental activities we have described. See Helpguide’s Getting the Sleep You Need: Sleep Stages, Sleep Tips and Aids for more information. Cardiovascular exercise Exercise is good for the mind, not just the body. Exercise can help with stress relief because it provides a way for the body to release tension and pent-up frustration (stress). It can also help stave off the depression that can set in when stress levels become too high by raising the output of endorphins—one of the ‘feel good’ chemicals in the brain. Any form of exercise can combat stress, but it is important that the activity be enjoyable, vigorous enough to discharge energy, and have a relaxing effect when you are finished. Yoga Practicing Yoga can have similar effects on the body and mind as practicing meditation. Yoga can force awareness to shift out of the mind and into the body. This transition happens through focusing on alignment of body and on breathing. There are also many poses that act as restorative yoga poses which bring the body in a conscious, awake state of rest. This not only relaxes the body but also calms the mind, helping to reduce the psychological triggers of stress. Ultimately, yoga can help to calm the activating nervous system, the sympathetic nervous system and stimulate the calming nervous system, the parasympathetic nervous system. Mindfulness Similarly practicing mindfulness has been shown to bring clinical improvement. Spending time in nature Psychologists today recognize the mental health benefits of spending time in the natural world. Activities done in nature tend to calm the mind and emotions, and to bring greater body awareness as a way to let go of mental stress. From taking walks in your neighborhood, to observing animals in the wild, to planting a garden, there are myriad ways to connect with the grounding and nurturing energy in nature. See the article Spending Time in Nature for suggestions on how to begin tapping the healing power of nature. Massage Therapy A professional massage from a trained therapist can provide soothing, deep relaxation and can improve important physiological processes such as circulation. A stress-relieving massage targets specific muscles that may be tense and painful. As the tense muscles relax, so does your overstressed mind. As massage has recently gained popularity as a stress reliever, the variety of different types of massage has changed. According to the American Massage Therapy Association (AMTA), the most common type of massage is a Swedish massage, which is specifically meant to relax and energize. Wilheim Riech proposed "body armor" as sets of muscles which rigidify in response to some stressor—he recommended sex as the release. Before visiting a massage therapist, you may want to visit the consumer section of AMTA’s website to learn more about what massage can do for you, what to expect from a massage, and how to find a qualified massage therapist. Meditation as a relief of stress The history of meditation goes back even further than that of Hatha Yoga, with its origins beginning around 3000 B.C. Meditation evolved as a way for the ancient spiritual seers—known in India as Rishis—to gain direct knowledge of the nature of the Ultimate Reality. Today, meditation is recognized for its myriad health benefits, and is widely practiced as a way to counteract stress. Meditation brings together all the energies of the mind and focuses them on a chosen point: a word, a sound, a symbol, an image that evokes comfort, or one’s own breathing. It is typically practiced in a quiet, clean environment in a seated posture with the eyes closed. As with yoga, a regular practice of meditation conditions you to bring the meditative state into your daily life. Holistic-online www.holistic-online.com reports that "hormones and other biochemical compounds in the blood indicative of stress tend to decrease during (meditation) practice. These changes also stabilize over time, so that a person is actually less stressed biochemically during daily activity." In meditation, there is both effort and passive participation. One continually brings attention back to a chosen focus (effort), and simply become a witness of all that transpires (passive participation), incorporating thoughts, sensory input, bodily sensations, and external stimulus into the meditation experience. The result of centering the mind in this way is a corresponding calming and relaxing of the body, down to the cellular level, providing stress reduction, by blocking out cognitive stressors and reducing physical ones. Stress and immunity There is substantial evidence that these physiological changes underly the relationship found between stress and compromised immunity. Folklore of stress It was gradually realized that such concepts as anxiety, antagonism, exhaustion, frustration, distress, despair, overwork, pre-menstrual tension, over-focusing, confusion, mourning, and fear could all come together in a general broadening of the meaning of the term stress. The popular use of the term in modern folklore expanded rapidly and created an industry of popular psychology, self-help, psychotherapy, and sometimes quackery. There were a series of films in the 30s, 40s, & 50s that dealt with mad scientists playing with hormones that seem related to this folklore. The use of the term stress in serious and recognized cases, such as those of post-traumatic stress disorder and psychosomatic illness, has scarcely helped clear analysis of the generalized "stress" phenomenon. Nonetheless, some varieties of stress from negative life events (distress) and from positive life events, (eustress) can clearly have a serious physical impact distinct from the troubles of what psychotherapists call the "worried well". Stress activates the sympathetic branch of the autonomous nervous system and the release of stress hormones including adrenaline/epinephrine, and cortisol. Sympathetic nervous output tends to divert bloodflow to the large muscles—the body 'thinks' it has to run away from something or fight something: the so-called 'fight or flight' response of ancient evolutionary heritage—and blood flows correspondingly less to the digestive system and other organs that are not immediately needed for a response to the stimulus. We all recognise the effects: dry mouth, motor agitation, sweating, pallor, enlarged pupils, and insomnia. Our modern lifestyle tends to cause continual sympathetic nervous system activation with very little opportunity for the parasympathetic (also called 'vegetative') nervous system to activate. When the parasympathetic system is active, the bowel and other non-muscle organs receive good blood-flow, the pupils constrict, and the glands all function well and secrete their various compounds. Absence of the autonomic parasympathetic activation leads to poor digestion and probably also to poor healing and organ function. It is vital to take time out from our modern lifestyles to allow for rest and proper parasympathetic action in our bodies. See also *Anxiety *Adjustment disorders *Critical Incident Stress Management *Distress *Endurance *Fight-or-flight response *Prenatal stress *Resilience *Strange situation *Stress management *Stress reactions References & Bibliography Key texts Books *Lefcourt, H. M. (1989). Personal and social characteristics that alter the impact of stressors. New York, NY: AMS Press. *Selye, H. (1956) The Stress of Life, New York: McGraw-Hill. Papers * Flinn, M.V. & England, B.G. (2003). Childhood stress: endocrine and immune responses to psychosocial events. In: Social & Cultural Lives of Immune Systems, J.M. Wilce (Ed.), pp. 107-147. London: Routledge press. Full text * Nesse R.M. & Young, E. (2000). Evolutionary Origins and Functions of the Stress Response. In G. Fink (Ed.), The Encyclopedia of Stress, Academic Press, NY, 79-84. Full text Additional material Books Papers *Google Scholar *Ulrich, R., et al. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology, 11 (3), 201-230. * Brennan, Richard (1998) "Mind and Body Stress Relief with the Alexander Technique" External links * Work Organisation Assessment - an online tool for employers to benchmark stress in the workplace * On-Line Stress Test * Stress Reduction Techniques * Stress News *How the Alexander Technique can help with all types of stress * Stress * Stress and psychosomatic symptoms * Stress in the Work Place * Stress and Young Children. * Stress Management for the Learning Disabled *Stress Anxiety and Depression Articles * Understanding and Managing Stress in the Academic World * Student Stress: Effects and Solutions * Promoting Stress Management: The Role of Comprehensive School Health Programs * Stress: Signs and Symptoms, Causes and Effects * Stress Management and Prevention at Work and at Home * Stress Relief: Meditation, Yoga, and Other Relaxation Techniques * Blood test can discover chronic stress - A web article * Stress & Burnout * APA interactive demo of physical/psychological effects of stress Category:Clinical psychology Category:Physiological psychology Category:Stress